Impact of COVID-19 on the Speech and Language Therapy Profession and Their Patients

Abstract

Introduction: The UK's response to the COVID-19 pandemic presented multiple challenges to healthcare services including the suspension of non-urgent care. The impact on neurorehabilitation professions, including speech and language therapy (SLT), has been substantial.Objectives: To review the changes to SLT services triggered by the COVID-19 pandemic with respect to referral rates, service delivery and outcomes, as well as examining the contribution of SLTs to the neurorehabilitation of COVID-19 patients.Methods: Two surveys were distributed to Royal College of Speech and Language Therapists (RCSLT) members exploring experiences of service provision at 6 weeks and 22 weeks after the pandemic was declared in the UK. Responses to closed-ended questions, including questions regarding referral numbers were analyzed descriptively and compared at the two time-points. A database comprising routine clinical data from SLT services across the UK was used to compare information on patients receiving services prior to and during the pandemic. Data on COVID-19 patients was extracted, and findings are provided descriptively.Results: Referrals to SLT services during the acute COVID-19 period in the UK were substantially less than in the same period in 2019. A number of service changes were common including adopting more flexible approaches to provision (such as tele-therapy) and being unable to provide services to some patients. Database analysis suggests fewer patients have accessed SLT since the pandemic began, including a reduction in neurorehabilitation patients. For those who received SLT, the outcomes did not change. SLTs supported a range of needs of COVID-19 patients. Treatment outcomes for COVID-19 patients with dysphagia were positive.Discussion: The pandemic has affected neurorehabilitation and SLT services broadly: referral patterns are different, usual care has been disrupted and interventions have been modified affecting the impact on patient outcomes both positively and negatively. Some patients with COVID-19 require and benefit from SLT intervention.

Psychological impact of COVID‐19 on speech and language therapists working with adult dysphagia: A national survey

“…Furthermore, there was inconsistent guidance supporting dysphagia assessment as an AGP (Bolton et al., 2020 ). All these issues contributed to uncertainty, and likely anxiety, amongst SLTs working with dysphagia during the pandemic (Chadd et al., 2021 ).…”

Establishing Clinical Swallowing Assessment Services via Telepractice: A Multisite Implementation Evaluation

“…While the loss of a champion can impact the viability of a model, studies have shown that services that continued after the loss of a champion achieved this by making telehealth part of standard services and an expectation of the clinicians' workload (Wade & Eliott, 2012). With increased use of telepractice by speech-language pathologists since the COVID-19 pandemic (Chadd et al, 2021;Fong et al, 2021), it is possible that high dependency on a single "champion" to lead the model may be minimized in the future, as more services adopt telepractice as core business in the delivery of SLP care. However, in the interim as services are still developing their telepractice competency, having team members to lead the implementation can be a key supporting strategy for implementation.…”

“…W hile still limited in depth and extent, the evidence supporting the use of telepractice within the field of adult speech-language pathology (SLP) services has grown substantially (Molini-Avejonas et al, 2015;Weidner & Lowman, 2020). However, aside from the recent unprecedented increase in SLP telepractice use created by the COVID-19 pandemic (Chadd et al, 2021;Fong et al, 2021), the implementation of telepractice into routine clinical care has remained slow and often fragmented (Keck & Doarn, 2014;May & Erickson, 2014). Numerous factors contribute to this, including clinician attitudes and perceptions, levels of available evidence, training, equipment access, funding/costs, and operational barriers (i.e., licensure laws, reimbursement; Dunkley et al, 2010;Hines et al, 2015;Keck & Doarn, 2014;May & Erickson, 2014;Miles et al, 2021;Raatz et al, 2020).…”

Intensive Comprehensive Aphasia Programmes: a systematic scoping review and analysis using the TIDieR checklist for reporting interventions

“…PIRATE highlighted that they achieved higher levels of follow-up data with participants when they expanded their methods of collection to assessments delivered via tele-practice [112]. Funding is being sought to run Australia's first tele-rehabilitation ICAP [146] and there has been a shift to the provision of therapy via video-conferencing software due to the COVID-19 pandemic [147] so a move away from face to face may be the natural evolution of ICAPs. There was a huge range in the staff/student to patient ratio varying from 16 staff/students for seven participants [108] to two SLTs for seven participants [109].…”